De Quervain's tenosynovitis is a condition that affects the tendons on the thumb side of the wrist. Specifically, it involves the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons, which run around the thumb side of your wrist and into the thumb itself. These tendons pass through a fibrous tunnel (the first dorsal compartment) at the wrist. When this tunnel becomes inflamed or thickened, it restricts the movement of the tendons, causing pain and swelling for many people, but particularly new mums and desk workers.
Common Signs and Symptoms of De Quervains’s tenosynovitis include pain and swelling. Typically, the pain is felt near the base of the thumb and can radiate up the forearm, and the pain often worsens with thumb and wrist movements, such as grasping or pinching. The swelling is common around the painful site and may be accompanied by a fluid-filled cyst. Some clients also suffer difficulty moving the thumb and wrist related to sticking sensation or stiffness, as well as the pain and swelling limitations.
During a physical assessment your OHL Physio is trying to differentiate whether it is De Quervains’s tenosynovitis from other conditions. Our thorough testing process is trying to determine whether there is concurrent and/or other condition looking similar like Thumb Carpometacarpal (CMC) Osteoarthritis, Intersection Syndrome, Flexor Carpi Radialis (FCR) Tendinitis or Radial Styloid Tenosynovitis. All these conditions are found local to the thumb and wrist, and need very different treatment plans, thus why we always recommend an assessment and not just guessing its ‘mum thumb’.
Treatment Options:
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Rest and Immobilization: Using a thumb spica splint to immobilize the thumb and wrist can help reduce symptoms and allow initial healing.
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Ice: Applying ice to the affected area can help reduce swelling and pain.
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Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce pain and inflammation, yet this is not first line care for tendon injuries. In very severe cases (terrible pain and/or unacceptable limitations on your life), a cortisone injection or surgery to the tendon sheath can be beneficial for pain relief and for you to be able to engage in the physio rehabilitation to ultimately resolve this tendon problem.
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Physiotherapy: Exercises to strengthen the wrist and thumb muscles and improve range of motion.
In summary, don’t let your hands become too painful without seeking assessment and a plan from an OHL Physiotherapist. Bookings via 9431 5955 and/or you can book via the Client Portal on the website.
